Immunocompromised Flashcards
(25 cards)
Describe the difference between a primary and an opportunistic pathogen?
Primary - can cause disease in healthy non immune hosts
Opportunistic - causes serious disease in immunocompromised, rarely in healthy
Describe the difference between primary and secondary immunodeficiency
Primary - result of the genetic effect
Secondary - acquired, as a result of the environment
What are the endogenous and exogenous sources of infection?
Endogenous - from the patient’s own body - eg e.coli from GI causing infection in urinary tract
Exogenous - external source
Give examples of primary and secondary immunodeficiencies
Primary
- chronic granulomatous disease (neutrophil or macrophage impairment)
- complement defect
- T defect / B defect
Secondary
- HIV
- diabetes
- cancer
What two pathogens are patients with the burns most susceptible to?
Pseudomonas and staph aureus
What type of bacteria are patients with splenectomy most susceptible to and why? Name them.
Most susceptible to capsule bacteria because the spleen’s function is to phagocyte the capsule
- pneumococci
- haemophilus
What two infections are pregnant women most susceptible to?
UTI and listeria (food, cheese)
Name 3 pathogens that individuals with HIV are most susceptible to
- pneumocystis jirovecii
- toxoplasmosis
- CMV
How does pneumocystis jirovecii present in patients with HIV?
- lung infections/pneumonias
- non-productive cough, fever
- perihilar infiltrate
How does toxoplasmosis present in patients with HIV?
- CNS lesions
- CT scan - ring lesions
- seizures, decreased consciousness
How do humans become infected with toxoplasmosis? Where from?
Cats faeces
What the are prophylaxis medication treatment in HIV patients for the following pathogens:
- pneumocystis
- mycobacterium avium intracellulare
- CMV
- pneumocystis - co-trimoxazole
- mycobacterium avium intracellulare - rifabutin
- CMV - ganciclovir
Define the classical Pyrexia of Unknown Origin
- pyrexia >38.3
- no obvious cause
- for 3 weeks
What categories of the Pyrexia of Unknown Origin exist? Name 4
- classical
- nasocomial
- neutropenic
- HIV associated
What is the difference between the different categories of the Pyrexia of Unknown Origin?
- classical >3 weeks
- nasocomial - hospital acquired
- neutropenic - neutrophils <500
- HIV associated - HIV present
What is the typical treatment Listeria monocytogenes?
ampicillin + gentamicin
What is the treatment of Listeria in pregnancy?
Ampicillin + gentamycin
What common organism causes diarrhoea in HIV?
Cryptosporidium parvum
What is the initial treatment of TB?
RIPE - all 4 drugs for 2 months
What complications can Chicken pox cause if a pregnant mother is exposed? When is she more susceptible and what can be done?
Complications:
- child - congenital varicella syndrome
- mother - pneumonitis
In particular if <20 weeks
Give VZIG - antibody within 10 days
How is Parvovirus B19 spread?
How is it treated if hydrops fetalis develops?
Via respiratory droplets
Fetal (intrauterine )transfusion is possible if hydrops develops due to B19 infection
What organism causes Infectious Mononucleosis?
EBV
How would you test for Infectious Mononucleosis?
Monospot serology
Which two antibiotics are nephrotoxic and ototoxic?
Gentomycin and Vancomycin
therefore calculate the dose carefully based on body weight AND lean body mass
